Lance Mandernack, BS, RTT

Primary specialty

Military General Acute Care HospitalTaxonomy code 2865M2000X

Practice address

3371 Glendale Blvd
#186
Los Angeles, CA 90039-1825

Phone

(323) 666-5364

NPI assigned

Feb 22, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1760651772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 GLENDALE BLVD",
            "address_2": "#186",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391825",
            "telephone_number": "323-666-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3371 GLENDALE BLVD",
            "address_2": "#186",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900391825",
            "telephone_number": "323-666-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDERNACK",
        "first_name": "LANCE",
        "credential": "BS, RTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2865M2000X",
            "taxonomy_group": "",
            "desc": "Military Hospital, Military General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Hugh Mandelberg, MD
• Rita Mandelenis
• Mark Alan Mandelkern, M.D.
• Faye Ingrid Mandell, LCSW
• Lindsey Summer Mandell, MA, AMFT
• Elda Mandi
• Tania Dafne Mandujano Lam Ortiz, AMFT
• Maria Guadalupe Mandujano
• Raksha Mane
• Jeffrie Maneepetasut, D.M.D

• Military Hospital in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Military Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.